A method and
system for performing
anastomosis uses an anvil to control and support a tissue site during an
anastomosis procedure involving tissue bonding techniques such as
tissue welding and
adhesive tissue bonding. The anvil is particularly useful for supporting a wall of a coronary
artery during attachment of a graft vessel in a coronary
artery bypass
graft procedure. The anvil is inserted into a pressurized or unpressurized
target vessel and is pulled against an inner wall of the
target vessel causing tenting of the thin tissue of the vessel wall. A graft vessel is then advanced to the
anastomosis site and an end of the graft vessel is positioned adjacent an exterior of the
target vessel. When
tissue welding is used, a graft vessel fixture is positioned over the tissue surfaces to be welded in order to clamp the graft and target vessel tissue together. The tissue contacting surfaces of the anvil and / or graft vessel fixture are provided with one or more energy applying surfaces. Energy in the form of RF power,
laser energy or ultrasonic energy is then applied to the compressed graft and target vessel tissue to weld the vessels together. When
adhesive bonding is used, the
adhesive may be applied to
mating surfaces of the graft and / or target vessels either before or after the vessels are brought into contact. After tissue bonding is complete, an incision is formed in the wall of the target vessel to allow
blood flow between the target vessel and the graft vessel. The incision may be made with an electro-cautery
cutting device.